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Occupational exposure to antineoplastic drugs in hospital environments: potential risk associated with contact with cyclophosphamide- and ifosfamide-contaminated surfaces

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Mucci N., Dugheri S., Farioli† A., Garzaro G., Rapisarda V., Campagna M., Bonari A., Arcangeli G.

Medycyna Pracy

2020

vol. 71

issue 5

519-529

BackgroundCyclophosphamide (CP) and ifosfamide (IP) contaminations have been detected in hospital environments. This study was conducted to determine if there was any contamination in the spaces (floors and door handles) between the hospital exit and the antineoplastic drugs (ADs) preparation and administration units. At the same time, the authors proposed a new automation of the analytical procedure to considerably decrease the time needed for sample preparation and analysis.Material and MethodsTo evaluate the ADs contamination of surfaces, 829 wipe tests were performed in a campaign involving 3 hospitals located in Italy. Sampling was performed using an innovative kit. The levels of ADs were measured in each wipe sample using liquid chromatography/triple quadrupole.ResultsOn-line solid-phase extraction guarantees the construction of a robust and reproducible analytical method. The CP and IP recoveries from stainless steel, polycarbonate and polyvinyl chloride ranged >80%, and the wipe holders and the automation tested ensured desorption efficiencies close to 100% for both the ADs. Of the 552 wipes taken on the spaces between the hospital exit and the preparation, administration and pharmacy warehouse units, 22 were greater than or equal to the limit of quantification, all adjacent to the administration units.ConclusionsThis study provides an insight into the exposure situation against ADs residues. In order to improve environmental monitoring programs, the authors propose to evaluate the ADs contamination also outside the preparation, administration and pharmacy warehouse units.

Health risk assessment related to hydrogen peroxide presence in the workplace atmosphere – analytical methods evaluation for an innovative monitoring protocol

100%

Mucci N., Dugheri S., Bonari A., Farioli A., Rapisarda V., Garzaro G., Cappelli G., Arcangeli G.

International Journal of Occupational Medicine and Environmental Health

2020

vol. 33

issue 2

137-150

ObjectivesHydrogen peroxide (HP) accounts for 15% of the total global chemical revenue. According to the National Institute of Occupational Safety and Health, the HP concentration immediately dangerous to human life or health is 75 ppm. Operators exposed to HP should pay attention when choosing the monitoring technique that should be specific and sensitive enough to discriminate the exposure levels from background concentrations. In order to assess the long- and short-term exposure to HP in disinfection processes, the authors compared 6 industrial hygiene monitoring methods to evaluate their efficiency in measuring airborne HP concentrations.Material and MethodsAirborne HP concentrations were evaluated using an on-fiber triphenylphosphine solid-phase microextraction method, and they were compared with those obtained using a 13-mm Swinnex titanium oxysulfate filter holder and 4 portable direct-reading electrochemical sensors. A survey carried out in wood pulp bleaching, food and beverage disinfection processing, and in a hospital department to reduce the risk of spreading nosocomial infections, was performed during routine operations to access the risk of HP occupational exposure.ResultsThrough the generation of HP gaseous dynamic atmospheres (0.1–85 ppm), the authors evaluated the consistency of the results obtained using the 6 methods described. The monitoring campaigns showed that the increase in HP could be relatively high (until 67 ppm) in food and beverage processing.ConclusionsIn the authors’ opinion, the current 8-h time-weighted average limits of 1 ppm for HP do not reflect the actual risk; a short-term exposure limit would, therefore, provide a much better protection.

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1 International Journal of Occupational Medicine and Environmental Health

1 Medycyna Pracy

2 Arcangeli G.

2 Bonari A.

2 Dugheri S.

2 Garzaro G.

2 Mucci N.

2 Rapisarda V.

1 Campagna M.

1 Cappelli G.

1 Farioli A.

1 Farioli† A.

2 2020

Search results

Occupational exposure to antineoplastic drugs in hospital environments: potential risk associated with contact with cyclophosphamide- and ifosfamide-contaminated surfaces

Health risk assessment related to hydrogen peroxide presence in the workplace atmosphere – analytical methods evaluation for an innovative monitoring protocol